Validation of the chinese version of the EORTC QLQ-CR29 in patients with colorectal cancer

AIM To assess the validity and reliability of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal Cancer 29(EORTC QLQ-CR29) in Chinese patients with colorectal cancer(CRC). METHODS From March 2014 to January 2015, 356 patients with CRC from four different hospitals in China were enrolled in the study, and all patients self-administered the EORTC QLQ-CR29 and the quality of life core questionnaire(EORTC QLQ-C30). Evaluation of the scores was based on the Karnofsky Performance Scale(KPS). The reliability and validity of the questionnaires were assessed by Cronbach's α coefficient, the Spearman correlation test and Wilcoxon rank sum test.RESULTS The EORTC QLQ-CR29 showed satisfactory reliability(α > 0.7), although the urinary frequency and blood and mucus in stool dimensions had only moderate reliability(α = 0.608). The multitrait scaling analyses showed good convergent(r > 0.4) and discriminant validity. Significant differences were obtained for each item in the different KPS subgroups(KPS ≤ 80; KPS > 80). body image and most single-item dimensions showed statistically significant differences in patients with a stoma compared with the rest of the patients. CONCLUSION The EORTC QLQ-CR29 exhibits high validity and reliability in Chinese patients with CRC, and can therefore be recommended as a valuable tool for the assessment of quality of life in these patients.

EORTC QLQ-CR29在结直肠癌患者生活质量评价中的应用

结直肠癌(colorectal cancer)又叫大肠癌,是常见的高发肠道肿瘤,是发达国家癌症的主要死亡原因之一,其居于男性常见肿瘤发病率第3位,女性常见肿瘤发病率第2位[1-2]。虽然我国结直肠癌的发病率低于欧美国家,但其在所有肿瘤发病率排名中位居第五,且以每年3.9%的速度上升,远高于国际平均水平2%[3]。

The EORTC QLQ-C30 and QLQ-CR29 may play a complementary role to LARS score in evaluating the quality of life for patients following laparoscopic and robotic rectal cancer surgery

Objective:To analyze whether the European Organisation for Treatment and Research of Cancer(EORTC)Quality of Life Questionnaires(QLQ-C30 and QLQ-CR29)complement the low anterior resection of rectum syndrome(LARS)score in evaluating the quality of life of patients who underwent laparoscopic or robotic rectal cancer surgery.Methods:Initially,335 patients who underwent laparoscopic or robotic rectal cancer surgery were randomly selected at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from June 2013 to September 2020.All the patients took the questionnaires of LARS score,QLQ-C30 and QLQ-CR29.Totally,questionnaires filled out by 224 patients were qualified after screening.Patients were divided into three groups according to LARS score:No LARS group(score 0-20),minor LARS group(score 21-29)and major LARS group(score 30-42).The scores of QLQ-C30 as well as QLQ-CR29 among the three groups were compared.Results:Major,minor and no LARS groups had 140 cases,40 cases and 44 cases respectively.In the scales of QLQ-C30,significant differences were discovered in global quality of life,physical function,role function,emotional function,cognitive function,social function,fatigue,pain,dyspnea,sleep disturbance,constipation and diarrhea between the no and major LARS groups(p<0.05).While the differences were only found in global quality of life and diarrhea between the minor and major LARS groups(p<0.05).In QLQ-CR29,scales of urinary frequency,blood and mucus in stool,body image,flatulence,fecal incontinence,sore skin,stool frequency,embarrassment,impotence,abdominal pain,buttock pain,bloating,dry mouth,hair loss,taste,anxiety and weight,had significant differences between the no and major LARS groups(p<0.05).Only six scales,ie blood and mucus in stool,flatulence,fecal incontinence,stool frequency,embarrassment and dysuria had significant differences between the minor and major LARS groups(p<0.05).Conclusion:For patients following laparoscopic or robotic low anal sphincter preserving surgery,LARS score,QLQ-C30 and QLQ-CR29 scores are consistent in overall trends.To guide disease evaluation and individualized treatment,as well as to evaluate efficacy,we suggest getting pre-and post-operative LARS scores incorporating QLQ-C30 and QLQ-CR29 scores as a comprehensive evaluation system.

结直肠癌患者的生活质量评估

结直肠癌是一种可治愈的高发恶性肿瘤,因此,研究人员和医务工作者需要对结直肠癌患者的术后生活质量给予足够的重视。为准确、有效地评估结直肠癌患者的生活质量,需要可靠的评估工具。本文采用文献回顾的方法,简要介绍结直肠癌患者的生活质量评估特异量表EORTC QLQCR 38和EORTC QLQ-CR 29,并对其发展和本土化进程进行详细阐述。